Julie A Matyasic, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601002675 Issued in MI

Practice address

463 E Circle Dr
East Lansing, MI 48824

Phone

(517) 884-6546

Fax

(516) 432-9460

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: julie.matyasic.1@25394.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan State University

  • Family Nurse Practitioner
  • East Lansing, MI
  • NPI 1639253784

  Physician Assistant

  NPD (past)
• Sams Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Leslie, MI
  • NPI 1306073945
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1437203130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 E CIRCLE DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48824",
            "telephone_number": "517-884-6546",
            "fax_number": "516-432-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 E CIRCLE DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48824",
            "telephone_number": "517-884-6546",
            "fax_number": "516-432-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATYASIC",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437203130",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beena Mathew, PT
• Cheyenne Brooke Matson
• Amanda Marie Mattingley, PA-C
• Emilia Elizabeth Mattioli, MD
• Bonnie Aline Matus, PTA
• Joseph Vincent Mauro, D.D.S.
• Dana Marie Maxwell, BCBA
• Aaliyah Alicia Mayes
• Lindsey Elise Maynard
• Hassan Mazloum

• Physician Assistant in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.